Etools presentation Paris 21 May 2013

John D Wark

Improving vitamin D status and related health in young women

Student Investigator: Emma Callegari*

Investigators include: Prof. John Wark, Prof. Steve Howard, Dr Nicola Reavley, A/Prof Marie Pirotta, Prof. George Varigos, Prof. Suzanne Garland, Prof Kim Bennell, Ms

Alexandra Gorelik, Prof. Anthony Jorm, Dr Tharshan Vaithianathan, Dr Shanton Chang and Stefanie Hartley (Project officer)

Study involvement: - Questionnaire - Site visit (comprehensive

health check) - Additional components:

smartphone application, physical activity monitor, UV monitor

Background

• Vitamin D deficiency: – Looming as a major public health issue – Potentially associated with risk of many chronic health conditions

affecting millions of Australians, leading to considerable suffering, economic loss and premature death.

– Important health risk for young women: up to 50% of Australian women are below currently-defined optimal vitamin D levels.

Study design and analysis

Recruitment of eligible participants, using targeted Facebook advertising

PART A: Questionnaire, UV dosimeter and study site visit

Randomize into PART B RCT those with baseline vitamin D levels 25-75 nmol/L

Control (general advice)

Behavioural Intervention (smartphone-delivered tailored

advice on sun exposure)

Pharmacological Intervention (Vitamin D supplements:

1000 IU/day)

Baseline Baseline Baseline

4-month assessment 4-month assessment 4-month assessment

12-month assessment 12-month assessment 12-month assessment

Part A: Baseline study Study Design: cross-sectional study

Study population: N= 468+ 16-25 year-old women

Exploratory aims:

• Define the statistical determinants of vitamin D status (e.g., sun exposure, weight/body mass index (BMI), skin colour, smoking, nutrition, physical activity, other lifestyle factors)

• Measure the relationship between UV exposure and actinic skin damage

• Assess young women’s knowledge about safe sun exposure

Secondary aim:

• Measure the relationship between 25 OHD levels and UV exposure under Australian conditions, examining both the overall dose and timing of sun exposure.

Primary aim:

• Investigate the association of 25 OHD levels with clinical health indices and related laboratory measures: musculoskeletal health (bone density, bone turnover markers, muscle function); mood/mental health; body composition and weight; and atopic/allergic symptoms.

• 2 hour online questionnaire successfully tested and completed in 160 YFHI launch study participants • Covers: participant demographics, medical history (incl. sexual history), lifestyle choices, SunSmart behaviour Individually validated questionnaires: • Diet: Cancer Council Victoria dietary questionnaire • Mental health: GAD-7 and PHQ-9

Online questionnaire

• NIWA - National Institute of Water and Atmospheric Research, New Zealand • NIWA has developed personal UV dosimeter badges • Small and lightweight • Robust & water resistant • Sampling interval of 4 seconds to 4 minutes

UV dosimeter

• Measures:

(1) Skin temperature,

(2) Heat flux

(3) Galvanic skin response,

(4) Body movements

(5) Steps

(6) Sleep amount and pattern

• Well validated in other

populations but not in young

Australians

9

SenseWear (SWA) – Activity Monitor

Calci-App

Expectations of the application:

Colour scheme and graphic tailored for young women

User-friendly and simple

Possibility to include search functions and saved selections for ease of entry on multiple uses

Includes pictures for easy visualization

Aim for application to be acceptable to young women and easy for them to comply with

Screenshot 1:

Welcome to Calci-App, [name of participant]!

To contact the YFHI Study Team, click here.

Start

About Calci-App

Instructions

• Silicone skin cast • Skin photographs - melanin - texture (wrinkles)

Site visit: Skin reflectance and casting

Site visit: Musculoskeletal Health

Bone densitometry: •DXA • pQCT Muscle health and balance: • Leonardo mechanography

1. First comprehensive study of vitamin D and related health in young women

2. Use of state-of-the-art LC-MS/MS method to measure vitamin D metabolites

3. Incorporates powerful and novel ICT for recruitment, data collection and interventions

4. By using ICT we are able to recruit subjects who may not seek medical care and are therefore not picked by the healthcare system

5. Behavioural interventions to (safely) improve vitamin D status have not been evaluated previously

Safe-D study significance

Acknowledgements

Acknowledgements

Melbourne EpiCentre Melbourne Physiology Department – Centre for Health, Exercise and Sports Medicine